Liu Shi-Qi, Wang Dong, Tang Cheng-Chun
School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China.
Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China.
World J Diabetes. 2025 Sep 15;16(9):107693. doi: 10.4239/wjd.v16.i9.107693.
The introduction of drug-eluting stents has significantly reduced the incidence of in-stent restenosis. Despite this, recurrent cardiovascular events related to untreated nontarget lesions (NTLs) are becoming more common and accounting for more than 50% of all recurrent cardiovascular events. In patients with diabetes, factors such as prolonged disease duration, poor glycemic control, insulin use, and inadequate lipid management may exacerbate the progression of NTLs and adverse cardiovascular events. Additionally, glycemic fluctuations have been linked to an increased risk of future cardiovascular events in patients with early glucose metabolism abnormalities and acute hyperglycemia. In this review, we explored the clinical and plaque characteristics of patients with diabetes and early glucose metabolism disorders, the percutaneous coronary intervention strategies for NTLs, and their prognostic implications. Furthermore, we investigated the mechanistic links between adverse cardiovascular outcomes and elevated inflammation, oxidative stress, hypercoagulability, and endothelial dysfunction.
药物洗脱支架的引入显著降低了支架内再狭窄的发生率。尽管如此，与未治疗的非靶病变（NTLs）相关的复发性心血管事件正变得越来越普遍，占所有复发性心血管事件的50%以上。在糖尿病患者中，病程延长、血糖控制不佳、使用胰岛素和脂质管理不足等因素可能会加剧NTLs的进展和不良心血管事件。此外，血糖波动与早期糖代谢异常和急性高血糖患者未来心血管事件风险增加有关。在本综述中，我们探讨了糖尿病和早期糖代谢紊乱患者的临床和斑块特征、NTLs的经皮冠状动脉介入治疗策略及其预后意义。此外，我们还研究了不良心血管结局与炎症、氧化应激、高凝状态和内皮功能障碍之间的机制联系。
